It is the policy of the laboratory to
notify the ordering location of any laboratory results which are
so far from the reference range that they indicate a potentially
dangerous condition requiring immediate attention by the clinician.
The ordering locations are notified even to those areas with computer
printers or terminals. Critical laboratory results are always
reported by telephone. In accordance with JCAHO requirements, it is required that we request a read-back of results to ensure that the results were properly noted by the recipient.

ANALYTE

CRITICAL VALUES

Absolute Neutrophil (non-oncology)

<0.5 THOU/µL

Bilirubin, newborn (under
30 days old)

>12.0 mg/dL

Blood Gases, Adult

pH
pCO2
pO2

<7.20 or >7.58
<9 or >65 mmHg
<40 or >350 mmHg

Blood Gases, Newborn

pH
pCO2
pO2

<7.25 or >7.50
<30 or >50 mmHg
<50 or >90 mmHg

Calcium, ionized

<0.78 or >1.58 mmol/L

Calcium, total

<7.0 or >13.0 mg/dL

Carbon Dioxide

<5 or >38 meq/L

Carbon Monoxide

>20%

Fibrinogen

<100 mg/dL

Glucose, adult

<45 or >500 mg/dL

Glucose, newborn

<40 or >200 mg/dL

Glucose, CSF

<20 mg/dL

Hematocrit

<20%

Hemoglobin by oximetry

<6.0 g/dL

Magnesium

<1.2 or >4.2 mg/dL

Osmolality

/

<250 or >350 mOsm/kg

Partial thromboplastin time

>120 sec

Phosphate

<1.0 mg/dL

Platelet Count

infants (NICU only)
non-Oncology

<60 THOU/µL
<20 THOU/µL

Potassium

<2.5 or >6.0 meq/L

Prothrombin Time

INR >5

Sodium

<120 or >152 meq/L

T4, adult

>18.0 µg/dL

T4, newborns

<3.5 or >18.0 µg/dL

Toxic
Drug Levels

Toxic Drug Levels are those results that
are so far from the therapeutic range that they indicate a potentially
dangerous condition requiring immediate attention by the clinician.
Critical laboratory results are always reported by telephone. In accordance with JCAHO requirements, it is required that we request a read-back of results to ensure that the results were properly noted by the recipient.

DRUG

TOXIC LEVEL

Acetaminophen

>300 µg/mL

Amikacin

>30.0 µg/mL

Carbamazepine

>14.0 µg/mL

Cyclosporine by HPLC

>600 ng/mL

Cyclosporine by Immunoassay

>700 ng/mL

Digoxin

>3.0 µg/mL

Disopyramide

>7.0 µg/mL

Ethosuximide

>150 µg/mL

Flecainide

>0.8 µg/mL

Gentamicin

>10.0 µg/mL PEAK

>2.0 ug/mL TROUGH

Isoniazid

>25 µg/mL

Lidocaine

>7.0 µg/mL

Lithium

>2.0 mmol/L

Mysoline

>15.0 µg/mL

Phenobarbital

>60.0 µg/mL

Phenytoin (Dilantin)

>30.0 µg/mL

Phenytoin, Free

>4.0 µg/mL

Procainamide

>15.0 µg/mL

Total Procainamide

>40.0 µg/mL (TPcain=
Pcain + NAPA)

Salicylate

>50 mg/dL

Theophylline

>25.0 µg/mL

Thiocyanate

>20 mg/mL

Tobramycin

>10.0 µg/mL PEAK

>2.0 µg/mL TROUGH

Tricyclic Antidepressants

>500 ng/mL

Quinidine

>7.0 µg/mL

Vancomycin

>40.0 µg/mL PEAK

>10.0 µg/mL TROUGH

Valproic Acid (VPA)

>150 µg/mL

Critical
Values for Microbiology

Critical Values in Microbiology are results
that indicate a potentially dangerous condition requiring immediate
attention by the clinician. Critical laboratory results are
always reported by telephone. In accordance with JCAHO requirements, it is required that we request a read-back of results to ensure that the results were properly noted by the recipient. They include the following: